Şevki KONUR, Refik DEMİRTUNÇ

Comparison of platelet count and mean platelet volume values before and after treatment in rheumatoid arthritis and ankylosing spondylitis patients receiving tumor necrosis factor alpha inhibitor therapy

Aim: In our study, we planned to reveal the change of the mean platelet volume (MPV) with anti-TNF treatment given in patients with Rheumatoid-Arthritis (RA) and Ankylosing-Spondylitis (AS) and to evaluate the clinical importance of MPV in the follow-up of these diseases.Materials and Methods: Patients who applied to our hospital's between 2011 and 2013 were included in the study. 40 patients participated in the study. The average ages of the patients were 43.8±9.9 years (range:25-68 years). All patients were examined retrospectively, Hemoglobin (Hb), Hematocrit (Hct), Platelet count, Mean Red-Blood-Cell Volume (MCV), MPV, Erythrocyte-Sedimentation-Rate (ESR), C-Reactive Protein (CRP) before anti-TNF treatment were recorded. Then, the same values were checked six months after the treatment. Averages of the Hb, Hct, MCV, PLT, MPV, CRP, ESH parameters of patients before and after treatment were compared with each other.Results: When the values before and after the treatment were compared, there was a significant decrease in ESR (p:0.002). There was also a statistically significant increase in Hb and Hct values after treatment (p:0.002, p:0.039, respectively). A significant decrease was observed in mean platelet count and MPV values after treatment (p:0.001). Although there was an increase in the MCV value, it was not statistically significant. Likewise, there was a decrease in CRP value but it was not statistically significant.Conclusion: In this study, it was concluded that the MPV value and platelet count could be inexpensive biomarkers in the follow-up of RA and AS. However, more controlled prospective studies are needed in this regard.

PDF

___

1. Myasoedova E, Davis J, Matteson EL, et al. Is the epidemiology of rheumatoid arthritis changing? Results from a population-based incidence study, 1985-2014. Ann Rheum Dis 2020;2019:216694.
2. Zhao J, Huang C, Huang H, et al. Prevalence of ankylosing spondylitis in a Chinese population: a systematic review and meta-analysis. Rheumatol Int 2020;20:35-47.
3. Otón T, Carmona L. The epidemiology of established rheumatoid arthritis. Best Pract Res Clin Rheumatol 2020;24:101477.
4. Braun J, Brandt J, Listing J, et al. Two year maintenance of efficacy and safety of infliximab in the treatment of ankylosing spondylitis. Ann Rheum Dis 2005;64:229- 34.
5. Heijde D. Dijkmans B, Geusens P, et al. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebocontrolled trial (ASSERT). Arthritis Rheum 2005;52:582-91.
6. Mei YJ, Mao YM, Cao F, et al. Using internet search data to explore the global public concerns in ankylosing spondylitis. Postgrad Med J 2020;24:16-22
7. Brandt J, Khariouzov A, Listing J, et al. Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum 2003;48:1667-75.
8. Barra L, Pope JE, Payne M. Real-world anti-tumor necrosis factor treatment in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: costeffectiveness based on number needed to treat to improve health assessment questionnaire. J Rheumatol 2009;36:1421-8.
9. Braun J, Sieper J. Therapy of ankylosing spondylitis and other spondyloarthritides: established medical treatment, anti-TNF-alpha therapy and other novel approaches. Arthritis Res 2002;4:307-21.
10. Rudwaleit M, Listing J, Brandt J, et al. Prediction of a major clinical response (BASDAI 50) to tumour necrosis factor alpha blockers in ankylosing spondylitis. Ann Rheum Dis 2004;63:665-70.
11. Keller C, Davis J. Cytokines in the seronegative spondyloarthropathies and their modification by TNF blockade: a brief report and literature review. Ann Rheum Dis. 2003;62:1128–32.
12. Yazici Y, Xie L, Ogbomo A, et al. Analysis of realworld treatment patterns in a matched rheumatology population that continued innovator infliximab therapy or switched to biosimilar infliximab. Biologics. 2018;12:127-34.
13. Francois RJ, Neure L, Sieper J, et al. Immunohistological examination of open sacroiliac biopsies of patients with ankylosing spondylitis: detection of tumour necrosis factor alpha in two patients with early disease and transforming growth factor beta in three more advanced cases. Ann Rheum Dis. 2006;65:713-20.
14. Trimova G, Yamagata K, Iwata S, et al. Tumour necrosis factor alpha promotes secretion of 14-3-3η by inducing necroptosis in macrophages. Arthritis Res Ther. 2020;22:24-32.
15. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-24.
16. Braun J, Vanden-Berg R, Baraliakos X, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2011;70:896-904.
17. Onen F, Akar S, Birlik M, et al. Prevalence of ankylosing spondylitis and related spondyloarthritides in an urban area of Izmir, Turkey. J Rheumatol 2008;35:305-9.
18. Wolfe F, Michaud K. Anemia and renal function in patients with rheumatoid arthritis. J Rheumatol 2006;33:1516-22.
19. Bath P, Algert C, Chapman N, et al. Association of mean trombosit volume with risk of stroke among 3134 individuals with history of cerebrovasculer disease. Stroke 2004;35:622-6.
20. Bancroft AJ, Abel EW, Mclaren M, et al. Mean trombosit volume is a useful parameter: a reproducible routine method using a modified Coulter Thrombocytometer. Trombosits 2000;11:379-87.
21. Gomi T, Ikeda T, Shibuya Y, et al. Effect of antihypertensive treatment on trombosit function in essential hypertension. Hypertens Res 2000;23:567- 71.
22. Basar O, Ertugrul I, Ibiş M, et al. Inflamatuvar Barsak Hastaliklarinda Ortalama Trombosit Hacmi Ölçümünün Hastalik Aktivitesi ile Iliskisi. Yeni Tıp dergisi 2007;24:46-7.
23. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96:776-81
24. Kisacik B, Tufan A, Akdogan A, et al. Mean Platelet Volume (OTH): As a inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291-4.
25. Yazici S, Yazici M, Erer B, et al. The platelet functions in patients with ankylosing spondilitis. Informa Healthcare 2009;21:126-31.